LABOR & DELIVERY

1. LABOR & DELIVERY OBJECTIVES You will be able to….. • Identify and describe stages of labor and delivery • Identify, describe and demonstrate helpful labor positions • Identify and describe different birthing methods and techniques • Analyze different birthing methods to determine effectiveness.

2. JOURNAL When you think about a person going through the process of labor and delivery, what comes to mind? List or write in paragraph form all the things that come to mind… explain WHY these are the things you think about.

3. Stages of Labor • Early • Active • Transition • Pushing • Birth • Afterbirth

4. Early Labor • Mild contractions- periodic tightening and relaxing of uterine muscles • Cervix is Effacing (thinning out) & Dilating (opening up) • Contractions will gradually become longer, stronger and closer together • Early labor is officially over when cervix is dilated to 4 centimeters and contractions get stronger and closer together • For first time mothers this stage can last 6-12 hours

5. Active Labor • Cervix begins to dilate more rapidly • Takes about 4-8 hours for cervix to fully dilate from 4-10 centimeters (first time moms) • During this time contractions last longer and are more painful • If contractions are too painful to handle, this is the time to ask for epidural

6. QUICK WRITE On the same page as your journal for today: No peeking at your notes!!! Write down 2 important facts about Early Labor and Active Labor (Yes- two each) No peeking at your notes!!!

7. Cervical Effacement & Dilation http://www.babycenter.com/2_video_3658872.bc

8. In your notes answer the following…. • Cervical Effacement means….. • Cervical Dilation means….. • It is important for the cervix to be fully dilated to 10 centimeters (4 inches) because……

9. Transition • Often referred to as the most challenging stage of labor • Powerful contractions dilate the cervix from 8-10 centimeters • Contractions come every 1-3 minutes and can last from 60-90 seconds • The baby has descended into the pelvis – mother may feel the urge to push

10. EVERYBODY STAND UP

11. LABOR POSITIONS SWAYING

12. LABOR POSITIONS LUNGING

13. LABOR POSITIONS SQUATTING

14. Labor Positions Think, Pair, Share (left-hand side of notebook) After trying out these positions how does you body feel? How do you think this might help a woman who is going through labor?

15. Pushing • Once the cervix is fully dilated, there will be a clear path for the baby’s head to follow • Mother will be encouraged to push with every contraction – will need extra coaching if pain meds are used • For first time mothers pushing can last for 1-2 hours • Mother may want to try different positions for pushing

16. Pushing • After a time the perineum (tissue between vagina and rectum will bulge • Top of baby’s head will become visible- Mother may request to touch and/or look at head with a mirror • This is usually a very exciting moment and a sign that the end is in sight! • Doctor may coach mother to slow down pushing in order to give tissues time to stretch • Slow, controlled pushing helps prevent tearing • Mother may be encouraged to use breathing techniques to counter the urge to push

17. REACH A CONSENSUS An epidural takes away all sensation from the waist down. How can this loss of sensation/feeling affect the transition and pushing stages of labor? Each group discuss for 2 minutes Reach a consensus Share with class

18. Birth of Baby!!! • Baby will continue to descend • Baby’s head will “crown” – the time when the widest part of the head is visible • After the baby’s head is completely out- doctor will suction mouth and nose (to remove mucus) • Doctor will also check to see if the cord is around baby’s neck • Baby’s head turns to the side as shoulder’s rotate to get into position to exit • Mother will be coached to push as shoulders emerge- one at a time- • After shoulders emerge- rest of baby slips out

19. Afterbirth • Umbilical cord is clamped and cut • Mother will feel some mild contractions as the placenta detaches from the uterus • Mother may be encouraged to push to help expel the placenta • Can take 5- 10 minutes for placenta to be delivered • Most babies will begin to breastfeed about an hour after birth • Early nursing is good for both mom and baby because it releases oxytocin which helps the uterus firm up and contract

20. Natural Childbirth • No medication, vaginal delivery http://www.youtube.com/watch?v=v3gvIKu7ANU&feature=player_embedded

21. C- Section http://www.babycenter.com/2_video_3656510.bc Abdominal Incisions

22. Water Birth • http://www.babycenter.com/2_live-birth-water-birth_3658855.bc • Water birth is a method of giving birth, which involves immersion in warm water.

23. Epidural • http://www.babycenter.com/2_live-birth-epidural_10314055.bc • Epidural is a regional anesthesia that blocks pain in a specific area or region of the body

24. Induced LaborInduce- to lead or move by influence • http://bcove.me/z5k00tog Various methods used to speed up the labor process

25. Episiotomy • Is a surgical cut in the muscular area between the vagina and the anus (the area called the perineum) made just before delivery to enlarge the vaginal opening • Expectant mothers should be sure to discuss this with their doctors to prevent an unnecessary episiotomy • Is not more beneficial than natural tearing- can actually cause more damage (anal incontinence)

26. Episiotomy

27. Postpartum Healing • New mothers will feel very sore and bruised after giving birth • It can take about 4 weeks for the uterus to shrink back to normal size • The place where the placenta was attached has open blood vessles, these will still bleed until the uterus contracts enough to close them off- takes a day or two • All of the extra blood and water the mother produced for the baby will need time to regulate. • New mother’s will have extra water that their body has to get rid of- extra urination and excessive sweating is how the body expels the extra water • Vaginal discharge of a substance called lochiais normal for a few weeks after birth, as the uterus continues to contract, heal and slough off tissues

28. Postpartum Healing • Hormonal changes will prompt the breasts to produce milk. BREAST MILK IS THE BEST MILK • All new mothers are encouraged to breast feed the first few days so the baby will receive colostrum a thick yellowish substance that contains rich nutrients and antibodies that protect the baby’s immune system • C-section requires extra healing time!!!

29. LAST 5 MINUTES…… • Look over notes • Think of one question you still have about labor & delivery • Write down • Answer next time